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MOD-DOC INC
NPI 1801627096
Nurse Practitioner - Primary Care in Kaysville, UT

Active since August 09, 2024CLIA 46D2329583 · Waiver
1188 W SPORTSPLEX DR STE 102, KAYSVILLE, UT 84037(801) 449-9229(385) 325-6055 Get Directions Write a Review

NPPES record last updated: April 27, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 27, 2026, Dec 17, 2025, Aug 9, 2024 (3 updates tracked since 2024).

About Mod-doc Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MOD-DOC INC (NPI 1801627096) is a healthcare organization registered as a primary care in Kaysville, Utah and active in the NPI registry since August 2024. The organization holds a CLIA Waiver certificate valid through September 1, 2027 and lists Jeff Midgley, Owner / President, as its authorized official.

NPPES Registry Identity

NPI1801627096
Entity TypeOrganization
Primary Taxonomy363LP2300X
Legal Business NameMOD-DOC INC
Location Address1188 W SPORTSPLEX DR STE 102Kaysville, UT 84037-6816
Mailing Address1188 W Sportsplex Dr Ste 102Kaysville, UT 84037-6816 · (801) 449-9229 · Fax (385) 325-6055
Phone(801) 449-9229
Fax(385) 325-6055
Organization SubpartNo
Authorized OfficialJeff MidgleyOwner / President · (801) 449-9229
Enumeration DateAugust 9, 2024
Last NPPES UpdateApril 27, 20263 updates tracked since enumeration
NPPES CertifiedApril 27, 2026
✔ NPI 1801627096 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
1188 W SPORTSPLEX DR STE 102, Kaysville, UT 84037
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mod-doc Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Mod-Doc Inc, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (2)

Mandi Cox, NP
Nurse Practitioner
NPI 1467184564
1741 N 2000 W STE 4
Ogden, UT 84404
(385) 470-0150
✔ PECOS18 mi
Donald Hastie, BC-FNP
Nurse Practitioner
NPI 1619900339
7611 JORDAN LANDING BLVD 200
West Jordan, UT 84084
(801) 260-1919
✔ PECOS✔ Accepts Medicare30 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 46D2329583

Mod Doc Kaysville LLC · Kaysville, UT
Active · expires Sep 1, 2027
CLIA Number46D2329583
Laboratory TypeCommunity Clinic
Certificate Effective DateSeptember 2, 2025
Certificate Expiration DateSeptember 1, 2027
Laboratory DirectorDonald R. Hastie
Laboratory Phone(801) 654-2042
Laboratory LocationMod Doc Kaysville LLC1188 W Sportsplex Dr, Suite 102, Kaysville, UT 84037
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mod-Doc Inc's NPI number?

The NPI number for Mod-Doc Inc is 1801627096. It was assigned to this organization in the NPPES registry on August 9, 2024.

Where is Mod-Doc Inc located?

Mod-Doc Inc is located at 1188 W Sportsplex Dr Ste 102, Kaysville, UT 84037. The listed phone number is (801) 449-9229.

What is Mod-Doc Inc's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Is Mod-Doc Inc enrolled in Medicare?

Yes. Mod-Doc Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Mod-Doc Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Mod-Doc Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Mod-Doc Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 46D2329583) is associated with this NPI, valid through September 1, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Mod-Doc Inc accept?

Health plans from BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah and University of Utah Health Plans list Mod-Doc Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mod-Doc Inc was last updated on April 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.